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https://www.readbyqxmd.com/read/28540478/immune-checkpoint-inhibitor-induced-colitis-diagnosis-and-management
#1
REVIEW
Caroline Prieux-Klotz, Marie Dior, Diane Damotte, Johann Dreanic, Bertrand Brieau, Catherine Brezault, Vered Abitbol, Stanislas Chaussade, Romain Coriat
Immune checkpoint inhibitors are monoclonal antibodies indicated for an increasing number of malignant diseases. These agents can cause specific side effects, which need to be anticipated while clear patterns of management need to be established. Immune checkpoint inhibitor-mediated gastrointestinal side effects, including diarrhea and colitis, occur in up to 30% of patients. Severe colitis can lead to severe dehydration or intestinal perforation. Endoscopic lesions and histopathological features of immune checkpoint inhibitor-induced colitis are similar to an inflammatory bowel disease (IBD) flare...
May 24, 2017: Targeted Oncology
https://www.readbyqxmd.com/read/28540197/decision-making-patterns-in-managing-children-with-suspected-biliary-dyskinesia
#2
Warapan Nakayuenyongsuk, Hassan Choudry, Karla Au Yeung, Wikrom Karnsakul
AIM: To explore and to analyze the patterns in decision-making by pediatric gastroenterologists in managing a child with a suspected diagnosis of functional gallbladder disorder (FGBD). METHODS: The questionnaire survey included a case history with right upper quadrant pain and was sent to pediatric gastroenterologists worldwide via an internet list server called the PEDGI Bulletin Board. RESULTS: Differences in decision-making among respondents in managing this case were observed at each level of investigations and management...
May 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#3
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28533672/effect-of-a-counseling-supported-treatment-with-the-mediterranean-diet-and-physical-activity-on-the-severity-of-the-non-alcoholic-fatty-liver-disease
#4
Chiara Gelli, Mirko Tarocchi, Ludovico Abenavoli, Laura Di Renzo, Andrea Galli, Antonino De Lorenzo
AIM: To determine the clinical effectiveness of nutritional counseling on reduction of non-alcoholic fatty liver disease (NAFLD) severity, weight loss, metabolic and anthropometric indexes and liver enzymes. METHODS: Forty-six adults with NAFLD received a 6-mo clinical and a dietary intervention (based on Mediterranean diet) carried out respectively by a gastroenterologist and a nutritionist with counseling license. The counseling process consisted of monthly meeting (about 45 min each)...
May 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28533660/genes-emotions-and-gut-microbiota-the-next-frontier-for-the-gastroenterologist
#5
REVIEW
Arturo Panduro, Ingrid Rivera-Iñiguez, Maricruz Sepulveda-Villegas, Sonia Roman
Most medical specialties including the field of gastroenterology are mainly aimed at treating diseases rather than preventing them. Genomic medicine studies the health/disease process based on the interaction of the human genes with the environment. The gastrointestinal (GI) system is an ideal model to analyze the interaction between our genes, emotions and the gut microbiota. Based on the current knowledge, this mini-review aims to provide an integrated synopsis of this interaction to achieve a better understanding of the GI disorders related to bad eating habits and stress-related disease...
May 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28533111/management-of-incidental-pancreatic-cysts-a-white-paper-of-the-acr-incidental-findings-committee
#6
Alec J Megibow, Mark E Baker, Desiree E Morgan, Ihab R Kamel, Dushyant V Sahani, Elliot Newman, William R Brugge, Lincoln L Berland, Pari V Pandharipande
The ACR Incidental Findings Committee (IFC) presents recommendations for managing pancreatic cysts that are incidentally detected on CT or MRI. These recommendations represent an update from the pancreatic component of the JACR 2010 white paper on managing incidental findings in the adrenal glands, kidneys, liver, and pancreas. The Pancreas Subcommittee-which included abdominal radiologists, a gastroenterologist, and a pancreatic surgeon-developed this algorithm. The recommendations draw from published evidence and expert opinion, and were finalized by informal iterative consensus...
May 12, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28532700/gastric-cancer-as-preventable-disease
#7
Massimo Rugge, Robert M Genta, Francesco Di Mario, Emad M El-Omar, Hashem B El-Serag, Matteo Fassan, Richard H Hunt, Ernst J Kuipers, Peter Malfertheiner, Kentaro Sugano, David Y Graham
Gastric cancer (GC), one of the five most common causes of cancer death, is associated with a 5-year overall survival rate less than 30%. A minority of cancers occurs as part of syndromic diseases; more than 90% of adenocarcinomas are considered as the ultimate consequence of a longstanding mucosal inflammation. H. pylori infection is the leading etiology of non-self-limiting gastritis, which may result in atrophy of the gastric mucosa and impaired acid secretion. Gastric atrophy establishes a field of cancerization prone to further molecular and phenotypic changes, possibly resulting in cancer growth...
May 19, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28532616/obesity-management-gastroenterologists-take-centre-stage
#8
EDITORIAL
The Lancet Gastroenterology Hepatology
No abstract text is available yet for this article.
May 19, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28531808/prenatal-diagnosis-of-biliary-atresia-a-case-series
#9
O Shen, H Y Sela, H Nagar, R Rabinowitz, E Jacobovich, D Chen, E Granot
BACKGROUND: Biliary atresia is a progressive disease presenting with jaundice, and is the most common indication for liver transplantation in the pediatric population. Prenatal series have yielded conflicting results concerning a possible association between BA and prenatal nonvisualization of the gallbladder. AIMS: This retrospective case series was performed to assess the association between biliary atresia, prenatal nonvisualization of the gallbladder and other sonographic signs...
May 19, 2017: Early Human Development
https://www.readbyqxmd.com/read/28531419/current-practices-and-experience-of-transition-of-young-people-on-long-term-home-parenteral-nutrition-pn-to-adult-services-a-perspective-from-specialist-centres
#10
E Kyrana, S V Beath, S Gabe, M Small, S Hill
BACKGROUND: There has been an estimated fivefold increase in the number of children receiving parenteral nutrition (PN) at home in the past 10 years with some children approaching the age when they should be referred to adult services whilst still on treatment. Models of care for moving young people onto adult providers of PN at home are not yet well developed, and transition is a potentially dangerous time for young people with complex health needs. METHODS: A questionnaire to ascertain current experience and practices of transition in the context of home PN services was dispatched to 170 consultant gastroenterologists who were members of the British Association of Parenteral and Enteral Nutrition (BAPEN) and also to all 40 members of the Nutrition and IF working group of the British Society of Paediatric Gastroenterology and Nutrition (BSPGHAN)...
August 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28528705/complications-of-proton-pump-inhibitor-therapy
#11
REVIEW
Michael F Vaezi, Yu-Xiao Yang, Colin W Howden
Safety issues associated with proton pump inhibitors (PPIs) have recently attracted widespread media and lay attention. Gastroenterologists are frequently asked about the appropriateness of PPI therapy for specific patients. Furthermore, some patients may have had PPI therapy discontinued abruptly or inappropriately due to safety concerns. Faced with such a wide variety of potentially serious adverse consequences, prescribers need to evaluate the evidence objectively to discern the likelihood that any reported association might actually be causal...
May 18, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28527200/contrast-enhanced-ultrasound-ceus-in-renal-imaging-at-an-interdisciplinary-ultrasound-centre-possibilities-of-dynamic-microvascularisation-and-perfusion
#12
Franz Josef Putz, Anna Erlmeier, Isabel Wiesinger, Niklas Verloh, Christian Stroszczynski, Bernhard Banas, Ernst Michael Jung
OBJECTIVE: To identify the indications for CEUS in renal imaging in an interdisciplinary ultrasound department. METHODS: 102 CEUS examinations of the kidney in 82 patients between September 2014 and July 2016 were analysed regarding the indication for ultrasound. CEUS was performed by one experienced sonographer agent after bolus injection of 1.0 up to 2.4 ml sulphur hexafluoride microbubbles using multifrequency probes with Contrast Harmonic imaging. RESULTS: CEUS of the kidney was performed in patients from 20 to 87 years...
May 19, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28522918/combination-of-corticosteroids-and-5-aminosalicylates-or-corticosteroids-alone-for-patients-with-moderate-severe-active-ulcerative-colitis-a-global-survey-of-physicians-practice
#13
Shomron Ben-Horin, Jane M Andrews, Konstantinos H Katsanos, Florian Rieder, Flavio Steinwurz, Konstantinos Karmiris, Jae Hee Cheon, Gordon William Moran, Monica Cesarini, Christian D Stone, Doron Schwartz, Marijana Protic, Xavier Roblin, Giulia Roda, Min-Hu Chen, Ofir Har-Noy, Charles N Bernstein
AIM: To examine treatment decisions of gastroenterologists regarding the choice of prescribing 5-aminosalycilates (5ASA) with corticosteroids (CS) versus corticosteroids alone for patients with active ulcerative colitis (UC). METHODS: A cross-sectional questionnaire exploring physicians' attitude toward 5ASA + CS combination therapy vs CS alone was developed and validated. The questionnaire was distributed to gastroenterology experts in twelve countries in five continents...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28522914/one-year-experience-with-computer-assisted-propofol-sedation-for-colonoscopy
#14
Otto S Lin, Danielle La Selva, Richard A Kozarek, Deborah Tombs, Wade Weigel, Ryan Beecher, Johannes Koch, Susan McCormick, Michael Chiorean, Fred Drennan, Michael Gluck, Nanda Venu, Michael Larsen, Andrew Ross
AIM: To report our one-year experience with computer assisted propofol sedation (CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use. METHODS: Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28521835/adult-autoimmune-enteropathy-presenting-initially-with-acquired-acrodermatitis-enteropathica-a-case-report
#15
Erina Lie, Sarah Sung, Steven Hoseong Yang
BACKGROUND: Acrodermatitis enteropathica (AE) is a rare dermatitis secondary to zinc deficiency most commonly seen as an inherited disease in infants. In the last decade, increased number of reports have been published on the acquired form that presents in adulthood. Unlike its inherited counterpart, acquired AE (AAE) is often secondary to underlying pathologic or iatrogenic etiologies that interfere with nutritional absorption, such as inflammatory bowel disease or alcoholism. Various gastrointestinal pathologies have been associated with AAE, but there is currently no report on its association with adult autoimmune enteropathy (AIE), a rare gastrointestinal disorder commonly seen in infants, with limited cases reported in adults...
May 18, 2017: BMC Dermatology
https://www.readbyqxmd.com/read/28516725/the-need-for-better-preventative-strategies-for-inflammatory-bowel-disease-patients-at-risk-of-herpes-zoster-virus
#16
William Bye, Miles Sparrow, Susie Connor, Jane Andrews, Katie Ellard, Watson Ng, Georgia Hume, Sally Antoniades, Alissa Walsh
BACKGROUND: Immunosuppressed IBD patients have an increased risk of HZV infection. The existing live-attenuated HZV vaccine is contraindicated in some of these patients and can only be used with caution in others. AIMS: To describe characteristics of IBD patients suffering HZV to enable implementation of risk mitigation strategies for those at highest risk. METHODS: Gastroenterologists completed a proforma for IBD patients who experienced HZV infection: IBD phenotype, details of HZV infection, immunosuppression and any change to treatment upon diagnosis of HZV...
May 17, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28512773/natural-history-of-intraductal-papillary-mucinous-neoplasm-and-non-neoplastic-cyst-long-term-imaging-follow-up-study
#17
Yuya Hisada, Naoyoshi Nagata, Koh Imbe, Yusuke Takasaki, Katsunori Sekine, Tsuyoshi Tajima, Mikio Yanase, Kazuma Fujimoto, Junichi Akiyama, Naomi Uemura
Pancreatic cyst is being detected with increasing frequency because of widespread use of sensitive abdominal imaging tests such as multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) [1, 2]. One study reported an incidental detection rate of 1% on MDCT studies performed for any reason [3]. Not only gastroenterologists, but also other physicians and surgeons, frequently encounter incidental pancreatic cyst. However, it is unclear how often and how long we should follow up patients with pancreatic cyst...
May 17, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28511188/calprotectin-in-daily-practice-where-do-we-stand-in-2017
#18
Fabrizia D'Angelo, Christian Felley, Jean Louis Frossard
BACKGROUND: To make a distinction between organic and functional disease is essential for gastroenterologists in their daily practice, but it may be challenging, given the variety and aspecificity of gastrointestinal symptoms among the general population. The clinician aim is to avoid diagnostic delay and to restrict unnecessary invasive and expensive exams. SUMMARY: Faecal markers, in particular faecal calprotectin (FC), have given proof of being reliable markers of intestinal inflammation with good clinical sensitivity...
May 17, 2017: Digestion
https://www.readbyqxmd.com/read/28509435/inpatient-iron-deficiency-detection-and-management-how-do-general-physicians-and-gastroenterologists-perform-in-a-tertiary-care-hospital
#19
Muhammad Waqas Fazal, Jane Andrews, Josephine Thomas, Eliana Saffouri
BACKGROUND: Iron deficiency (ID) is often an indicator of underlying pathology. Early detection and treatment avoids long term morbidity, and allows for prompt iron repletion avoiding ID anaemia (IDA) and need for blood transfusion. AIM: We aimed to evaluate the management of ID in two internal medicine units [General Medical (GM) & Gastroenterology (GE)] in a large metropolitan hospital and compare it to international guidelines.(3,4) METHOD: All consecutive inpatient admissions under GM & GE units were retrospectively reviewed until 40 patients in each service were identified with anaemia and/or microcytic hypochromic blood counts...
May 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28507746/guidelines-on-eosinophilic-esophagitis-evidence-based-statements-and-recommendations-for-diagnosis-and-management-in-children-and-adults
#20
REVIEW
Alfredo J Lucendo, Javier Molina-Infante, Ángel Arias, Ulrike von Arnim, Albert J Bredenoord, Christian Bussmann, Jorge Amil Dias, Mogens Bove, Jesús González-Cervera, Helen Larsson, Stephan Miehlke, Alexandra Papadopoulou, Joaquín Rodríguez-Sánchez, Alberto Ravelli, Jukka Ronkainen, Cecilio Santander, Alain M Schoepfer, Martin A Storr, Ingrid Terreehorst, Alex Straumann, Stephen E Attwood
INTRODUCTION: Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE...
April 2017: United European Gastroenterology Journal
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